Management of nausea and vomiting in palliative care

Neoh, Karen; Adkinson, Lucy; Montgomery, Victoria; Hurlow, Adam

doi:10.12968/hmed.2014.75.7.391

Cited by 6 publications

(4 citation statements)

References 13 publications

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“…Opioids have three potentially nausea-inducing mechanisms; it has a direct effect on the chemoreceptor trigger zone, enhanced vestibular sensitivity, and delayed gastric emptying [ 10 ]. For patients with opioid-induced nausea, metoclopramide is the first-line treatment [ 11 ]. For nausea-refractory cases, atypical antipsychotics, such as olanzapine or risperidone, can be initiated [ 12 ].…”

Section: Discussionmentioning

confidence: 99%

“…If suspected, imaging should be considered, as it will provide directed symptom management. Studies have shown that metoclopramide is a reasonable initial choice for nausea management of palliative patients with unclear etiology [ 11 ]. Haloperidol is often used as a second-line drug for those who have contraindications or refractory to metoclopramide [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

“…Studies have shown that metoclopramide is a reasonable initial choice for nausea management of palliative patients with unclear etiology [ 11 ]. Haloperidol is often used as a second-line drug for those who have contraindications or refractory to metoclopramide [ 11 ]. It is also first-line therapy for patients with non-operable bowel obstruction as well as chronic kidney disease patients with uremic-induced nausea [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

“…Haloperidol is often used as a second-line drug for those who have contraindications or refractory to metoclopramide [ 11 ]. It is also first-line therapy for patients with non-operable bowel obstruction as well as chronic kidney disease patients with uremic-induced nausea [ 11 ]. Olanzapine has also been shown in studies to be an effective alternative or adjunct therapy for advanced cancer patients with no clear etiology for nausea and vomiting (Figure 1 ) [ 12 ].…”

Section: Discussionmentioning

confidence: 99%

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Emergency Department Management of Common End-of-Life and Palliative Care Symptoms: Three Cases

Chang,

Espinosa,

Lucerna

2024

Cureus

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The emergency department (ED) is at times the only place where patients can turn for symptom relief. Patients of all ages may turn to the ED for help with the management of end-of-life (EOL) and palliative care (PC) symptoms. Emergency medicine (EM) is a specialty that manages disease-directed treatment for a variety of acute conditions. In contrast, EOL and PC are focused on improving quality of life. Patients with serious illness, even hospice patients, present to the ED in increasing numbers for symptom management. It has become essential for emergency physicians to care for patients who are not seeking life-sustaining measures but instead need quality-of-life interventions. The development of a clear, concise review of the most common acute symptoms can provide a framework for EM physicians to adequately address the needs of patients at the EOL. Here, we discuss three cases that highlight the management of five of the most common EOL and PC presentations to the ED.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Emergency Department Management of Common End-of-Life and Palliative Care Symptoms: Three Cases

Chang,

Espinosa,

Lucerna

2024

Cureus

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Post-operative nausea and vomiting: Update on predicting the probability and ways to minimize its occurrence, with focus on ambulatory surgery

Öbrink¹,

Jildenstål²,

Oddby³

et al. 2015

International Journal of Surgery

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Postoperative nausea and vomiting "the little big problem" after surgery/anaesthesia is still a common side-effect compromising quality of care, delaying discharge and resumption of activities of daily living. A huge number of studies have been conducted in order to identify risk factors, preventive and therapeutic strategies. The Apfel risk score and a risk based multi-modal PONV prophylaxis is advocated by evidence based guidelines as standards of care but is not always followed. Tailored anaesthesia and pain management avoiding too liberal dosing of anaesthetics and opioid analgesics is also essential in order to reduce risk. Thus multi-modal opioid sparing analgesia and a risk based PONV prophylaxis should be provided in order to minimise the occurrence. There is however still no way to guarantee an individual patient that he or she should not experience any PONV. Further studies are needed trying to identify risk factors and ways to tailor the individual patient prevention/therapy are warranted. The present paper provides a review around prediction, factors influencing the occurrence and the management of PONV with a focus on the ambulatory surgical patient.

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Symptom assessment and management at the end of life

Noortgate¹,

Sampson²

2017

Oxford Textbook of Geriatric Medicine

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As people age, the number and complexity of illnesses they develop increases. Symptoms during the last year of life in older persons are often a combination of the underlying life-threatening illness and other chronic conditions. These may be complicated by psychosocial and spiritual needs, related to life events such as bereavement. Geriatric palliative medicine involves the care and management of older patients’ progressive advanced disease, for whom the aim is quality of life. It focuses on detailed geriatric assessment, relief from pain and other symptoms such as anorexia, constipation, or delirium, and also management of psychological problems including depression or anxiety. This may be more challenging in people with cognitive impairment who may not be able to express whether they are in pain or otherwise suffering. Adequate pain and symptom management at the end of life emphasizes the need for a tailored multidisciplinary approach for patients and their family.

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Management of nausea and vomiting in palliative care

Abstract: Nausea and vomiting are common symptoms in palliative care and can be highly distressing to patients. This review discusses the mechanisms by which nausea and vomiting are triggered, using case studies to highlight the most common scenarios and how to manage these.

Cited by 6 publications

References 13 publications

Emergency Department Management of Common End-of-Life and Palliative Care Symptoms: Three Cases

Emergency Department Management of Common End-of-Life and Palliative Care Symptoms: Three Cases

Post-operative nausea and vomiting: Update on predicting the probability and ways to minimize its occurrence, with focus on ambulatory surgery

Symptom assessment and management at the end of life

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